Wednesday, April 15, 2015

Scurvy, now known to be caused by a lack of vitamin C, is one of the world's oldest and most devastating deficiency diseases. Historians have been describing scurvy since ancient times primarily because the disease so often seemed to attack invading armies, sailors on long sea voyages, explorers, and even crusaders. For example, it was scurvy, rather than savage storms or hostile natives, that killed many of the crewmen who sailed with Vasco da Gama (1469-1524) in 1498 and with Ferdinand Magellan (1480-1521) in 1519.

Scurvy begins innocently enough, usually with mild fatigue, bleeding gums, and hemorrhagic bruises on the skin. However, after several months of a diet lacking any vegetables or fruits, worsening physical condition continues, resulting in weakened bones, loose teeth which ultimately fall out, severe joint pain, profuse bleeding from a simple cut, anemia, and eventually death.

Fortunately for later researchers, folk remedies for scurvy occasionally appeared in historical accounts. In 1536, for instance, Jacques Cartier (1491-1557) arrived in Newfoundland deeply concerned about the epidemic of scurvy among his crew members. Friendly Indians advised Cartier to give his men an extract of needles from a local tree (thought be white cedar or spruce). Cartier did so and found that almost all his men showed remarkable improvement. During that same century, several other writers reported similar dramatic cures from (among other foods) cloudberries, oranges, and lemons.

Nevertheless, Scottish naval surgeon, James Lind (1716-1794), is generally credited with being the first to discover the cure for scurvy. Shortly after the long sea voyage of Admiral George Anson (1697-1762), from 1740 to 1744 during which more than a thousand sailors out of a crew of 1,955 died primarily from scurvy, Lind began his own investigations into the disease.

From his readings of historical accounts, Lind realized that scurvy might be due to some dietary lack. In 1747, therefore, the physician began treating stricken sailors with various foods, and soon found that citrus fruits produced the fastest and most effective cures. Although Lind published his Treatise on the Scurvy in 1753, it was not until 1795 that the Admiralty prescribed a daily ration of lime juice for all British sailors (Lind's cure gave British sailors their nickname--"limeys"). Scurvy promptly diminished in the British navy; however, for the most part, the rest of the civilized world continued to ignore Lind's findings and to resist the idea that scurvy might be related to a dietary deficiency. During the American Civil War, then, scurvy was still killing soldiers in both the Union and Confederate armies. Ironically, even as late as 1912 when Robert Scott (1868-1912) explored the South Pole,he and his team succumbed not to the intense cold, but to the lack of fruits and vegetables in their diet.

In 1907, two Norwegian biochemists, Axel Holst (1861-1931) and Alfred Frohlich (1871-1953), proved conclusively that a scurvy-like condition could be produced in the guinea pig (one of the few animals unable to synthesize vitamin C from their intestinal bacteria) by restricting certain foods. Equally important, Holst and Frohlich then cured the lab animals by feeding them cabbage. The scientific community was finally convinced that the lack of a specific nutrient must be causing scurvy, and an intensive search began to find the nutrient. The antiscorbutic (or anti-scurvy) factor was not isolated until 1928, however. In that year, two teams of researchers, one headed by Albert Szent-Györgyi in Hungary, the second by Charles G. King in the United States, extracted an antiscorbutic substance from a variety of fruits. The substance was named vitamin C, or ascorbic acid which, in 1933, was synthesized by two other chemists, Norman Haworth (1883-1950) and Tadeus Reichstein.

Soon afterward, vitamin C became the first vitamin to be artificially produced and, once marketed for medical purposes, marked the end of scurvy as a deadly disease. Today, those populations in the United States at high-risk for scurvy include alcoholics, drug abusers, and elderly men who live alone and who may experience extremely poor diets.